Medical Billing & Coding Changes

Healthcare is constantly evolving, attempting to change things for the best for both patient and provider. For the last several years the Covid-19 Pandemic has altered many areas and numerous more lives.

 

This year, has changed 4 things significantly, that will specifically be impacting medical billing & coding:

 

• IPPS (Inpatient Prospective Payment System – The Medicare Hospital increased reimbursement for hospitals by 2.5% while also enhancing rates due to Covid-19. These changes came with new diagnostic and procedure codes but also with Medicare severity diagnosis-related adjustments.

 

• Medicare Physician Fee Schedules – substantial changes include: increased payments for some specialties while reducing payment for others, E/M reporting services, and expanding a significant list of available telehealth services.

 

• New Medical Codes – due to the covid-19 pandemic, billers and coders had to learn a whole new slew of items from CPT to HCPC codes never before invented or used. Now, moving forward, there are: 159 new codes, 22 revised, along with 30 invalidated codes. New programming ICD-11 went into effect this year with a gigantic platform of 17,000 diagnostic categories.

 

• Claims Denials – specifically due to Covid-19 related care, up to 40% of claims were died for numerous reasons. Now, with 2022 underway, providers and billers will need to work together to mitigate these denial reasons.

 

Inner Circle Billing is here to help navigate these changes to aid in improving your facility or practice with effective and affordable and precise medical billing care.